HealthSheets™

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Multidrug-Resistant Organisms (MDROs)

Washing hands often helps prevent the spread of bacteria.

Some bacteria have become resistant to the antibiotics used to treat them. This means the antibiotics can no longer kill those germs. Bacteria that resist treatment with more than one antibiotic are called multidrug-resistant organisms (MDROs). MDROs mainly affect people in hospitals and long-term care facilities. But they are also spreading among healthy children and adults. A person may be a carrier or may have the infection.

Colonization. When a person carries the MDRO bacteria but is healthy, it's called being colonized. This person can spread the MDRO to others but has no symptoms of infection .

Infection. When a person gets sick because of the bacteria, it's called being infected with the MDRO. This person can also spread the MDRO to others. If not treated properly, MDRO infections can be very serious and even cause death.

What causes MDROs?

MDROs are caused by the misuse of medicines that treat bacterial infections (antibiotics). Misuse is when antibiotics are taken longer than necessary. It also happens when they are not taken long enough, or taken when they are not needed. At first, only a few bacteria may survive treatment with an antibiotic. But the more often antibiotics are used, the more likely it is that resistant bacteria will develop.

What are the risk factors for MDROs?

Anyone can be colonized or infected by an MDRO. But certain risk factors make this more likely. These include:

Living with or having close contact with a person who is infected or colonized

Sharing items with a person who is infected or colonized

Having a serious illness or weakened immune system

Recent hospital stay

Living in a nursing home or long-term care facility

Antibiotic treatment

Having medical procedures, such as kidney dialysis

Having a medical device, such as a tube placed in the bladder to drain urine (urinary catheter)

Previous MDRO colonization or infection

Older age

How are MDROs spread?

People who are colonized with an MDRO often carry the germs on the skin and in the body. These people are not sick. But they can spread the MDRO to others.

In hospitals and long-term care facilities, MDROs are often spread on the hands of healthcare workers. The germs can also spread on objects such as cart and door handles, and bed rails.

Outside healthcare settings, MDRO infections usually spread through skin-to-skin contact, shared towels, or athletic equipment, or through close contact with an infected person.

How are MDRO infections diagnosed?

The infected area is swabbed or a sample of tissue is taken and sent to the lab. In the lab, the bacteria is identified and tested for resistance to antibiotics.

What types of infections can MDROs cause?

MDROs can cause infections in almost any part of the body, including:

Skin

Lungs

Urinary tract

Bloodstream

Wounds

How are MDRO infections treated?

MDRO colonization does not usually need treatment. But people are advised to avoid spreading MDRO to others. Depending on the type of MDRO a person has, he or she may undergo a process called decolonization. Your healthcare provider will let you know more about this treatment if needed.

MDRO infections can be hard to treat. This is because they don’t respond to many common antibiotics. But some antibiotics remain effective against MDRO's and are routinely prescribed. Your healthcare provider will test for the type of MDRO causing the illness and choose the best antibiotic.

Can MDRO infections be prevented?

Handwashing. This is the single most important way to prevent the spread of germs. Health care workers should wash their hands with soap and water before and after treating each patient. Or they should use an alcohol-based hand cleaner before and after treating each patient. They should also clean their hands after touching any surface that may be contaminated and after removing protective clothing.

Protective clothing. Healthcare workers and visitors wear gloves, a gown, and sometimes a mask when they enter the room of a patient with an MDRO. The clothing is removed before leaving the room.

Careful use of antibiotics. Using antibiotics only when needed and for the shortest time possible helps prevent the growth of more antibiotic-resistant bacteria.

Private rooms. People with MDRO infections are placed in private rooms. Or they may share a room with others who have the same infection.

Daily cleaning. All patient care items, equipment, and room surfaces are cleaned and disinfected every day.

Vaccination. Vaccines help prevent problems caused by MDRO infections, such as pneumonia.

Monitoring. Hospitals monitor the spread of MDROs and educate all staff on the best ways to prevent it.

Patients can help prevent MDRO infections by doing the following:

Ask all hospital staff to wash their hands before touching you. Don’t be afraid to speak up!

Wash your own hands often with soap and water. Or use an alcohol-based hand gel.

Ask that stethoscopes and other instruments be wiped with alcohol before they are used on you.